Every patient has a right to get fair and effective medical care services and if professional care is delivered by the nurses or the medical staff then legal actions can be filed against the law violator. It is often found that nurses face many legal and ethical dilemmas in nursing therefore, they are expected to follow the ethical principles – autonomy, beneficence, non-maleficence, and justice (Heale and Shorten 2017). Moreover, the Nursing and Midwifery Board of Australia (NMBA) standards and decision-making framework should be kept in mind while delivering care to the patients. The following sections of the summary will discuss the ethical, legal, and professional principles and standards of nursing care to the patient in the case study.
In the case study of Victoria, it is found that the ethical principle of beneficence was maintained because the mental health care staff arrived at her home to assess and as per her mental health status they found that it is required to admit her immediately to the hospital, thereby using the standard 7 of evaluation of the health outcomes (Nursing and Midwifery Board of Australia 2020). It is the duty of the nurse to exhibit professionalism while delivering care to the patient and monitor and document her health status to determine the goals and priorities of the medical care that will be delivered to her. The standards of 5 development of the plan were also maintained in this case study of Victoria because she was provided with patient-centered medical care such as medications and frequent monitoring and evaluation of her health status. This also shows that the ethical principle of justice was maintained as she was given a fair treatment. This shows that the medical staff was successful in non-violation of the law of breach of duty and negligence of care. However, autonomy was violated because she was administered with medication without her consent. She refused to continue the care delivered by the nurse but her decision was not respected.
In this case, it was found that principle 2.2 of decision-making and 2.3 of informed consent was violated. This is because as per the law of informed consent to medical treatment all patients have a right to make decisions for their care. If this law is violated then legal actions can be taken against the nurse or health professionals (Nursing and Midwifery Board of Australia 2020). However, this common law states that there is a situation in nursing care when the patient is unable to make decisions for her medical care and in such cases, either the family members or the medical staff can take action as per the emergency of the situation (Australian Law Reform Commission 2014; Mallari and Joseph 2016). This shows that statement 1 of the decision-making framework was maintained effectively by delivering a careful and planned care to her such as collaboration of the multidisciplinary team to monitor her and timely provide her with tablets or other medicines (McDermott-Levy, Leffers and Mayaka 2018; Moen, Skundberg-Kletthagen and Lundquist 2020). It was also found the principle of 3.3 of effective communication was not appropriately followed because initially, the patient was cooperative and quiet but at later stages, she had no trust over the nurses who were delivering care to her (Nursing and Midwifery Board of Australia 2020). If there is no effective communication with the patient then there will be no trust development and the patient-nurse relationship will be poor. In such a situation, the patient will not be able to express her feelings and needs for the care and culturally safe care might not be delivered and the approach of a patient-centered acre might get affected.
It was also found that there was no family involvement during the entire period of care delivery to the patient. Communication in mental health is of great significance as it helps the mentally ill patient to show her expressions, reduce the risks of stress or depression, and enable the care provider to record the feedback from the patient about the care, emotion, and feelings during the treatment (Furnes, Kvaal and Høye 2018). This will help the medical health professionals to develop an effective care plan for the patient for improved outcomes. Statement principle 4 of the decision-making framework was maintained for the safety of the patient. It was found that Victoria was getting a bit aggressive that might hurt her or the care providers so that the medical staff decided to administer her with intramuscular sedatives (Nursing and Midwifery Board of Australia 2020). It is the duty of the nurse or the medical staff to ensure the ethical principle of non-maleficence so that there is no harm to the patient. It is the duty of the nurse to educate the patient about her decisions in association with the risks or benefits of her decision (Queensland Health 2017). Moreover, a safe environment should be maintained in the workplace so that other patients do not get stress by observing any loud noise or incident that disturbs their peace or healthy state of mind (Santangelo, Procter, and Fassett 2018).
It is concluded that it is the responsibility of the nurse or the medical health professionals to ensure the ethical or professional nursing practice principle of NMBA or standard is maintained. This is because if any of the law is violated while delivering acre to the patient then the patent has complete right to file a legal action against the lawbreaker. It should be ensured that safe and patient-centered care is delivered to the patient. There should be effective communication with the mentally ill patient and the principle statements of the decision-making framework should be followed.
Australian Law Reform Commission. 2014. Informed consent to medical treatment. Retrieved from: https://www.alrc.gov.au/publication/equality-capacity-and-disability-in-commonwealth-laws-dp-81/10-review-of-state-and-territory-legislation/informed-consent-to-medical-treatment/
Furnes, M., Kvaal, K.S. and Høye, S. 2018. Communication in mental health nursing-Bachelor Students' appraisal of a blended learning training programme-An exploratory study. BMC Nursing, vol. 17, no. 1, pp.20. https://doi.org/10.1186/s12912-018-0288-9
Heale, R. and Shorten, A. 2017. Ethical context of nursing research. Evidence-based Nursing, vol. 20, no. 1, pp.7-7. http://dx.doi.org/10.1136/eb-2016-102514
Mallari, M.G.D. and Joseph, D. 2016. Ethical frameworks for decision-making in nursing practice and research: An integrative literature review. Journal of Nursing Practice, vol. 7, no. 1. https://doi.org/10.13178/jnparr.2017.0701.0707
McDermott-Levy, R., Leffers, J. and Mayaka, J. 2018. Ethical principles and guidelines of global health nursing practice. Nursing Outlook, vol. 66, no. 5, pp.473-481. https://doi.org/10.1016/j.outlook.2018.06.013
Moen, Ø.L., Skundberg-Kletthagen, H., Lundquist, L.O., Gonzalez, M.T. and Schröder, A. 2020. The relationships between health professionals’ perceived quality of care, family involvement and sense of coherence in community mental health services. Issues in Mental Health Nursing, pp.1-10. https://doi.org/10.1080/01612840.2020.1820119
Nursing and Midwifery Board of Australia (NMBA). 2020. Decision-making framework (DMF). Retrieved from: https://www.nursingmidwiferyboard.gov.au/codes-guidelines-statements/frameworks.aspx
Nursing and Midwifery Board of Australia (NMBA). 2020. Professional standards. Retrieved from: https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards.aspx
Queensland Health. 2017. Guide to informed decision-making in health care. Retrieved from: https://www.health.qld.gov.au/__data/assets/pdf_file/0019/143074/ic-guide.pdf
Santangelo, P., Procter, N. and Fassett, D. 2018. Mental health nursing: Daring to be different, special and leading recovery‐focused care?. International Journal of Mental Health Nursing, vol. 27, no. 1, pp.258-266. https://doi.org/10.1111/inm.12316
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